Five Health Issues Women with Diabetes Face and What to Do: Our bodies, our diabetes
5 health issues women with diabetes face and what to do about them
Donna was surprised when her doctor told her she had diabetes. The diagnosis occurred during a visit for a recurring yeast infection. She never guessed that the problem could be due to diabetes.
The American Diabetes Association (ADA) reports there are about 9.7 million women in the United States today who have diabetes. One third don’t know they have it. And women with diabetes are at increased risk for a number of sexual and urologic conditions. Here are five you should know about—and what to do.
Vaginitis and yeast infections
Vaginitis is an inflammation of the vagina often caused by yeast infections. Yeast is a fungus that lives in warm, moist, dark environments. The vagina is such a place. This fungus, which is always present in the vagina in small amounts, is fed by sugar (glucose) so when a woman’s blood sugar is elevated, her vagina is a perfect environment for the yeast to live, be fed and grow. Symptoms include itching, burning or pain during urination or intercourse.
The good news is that getting blood sugar under control—the ADA recommends an A1C of less than 7 percent—will help treatments for yeast infections work—and give you some relief.
Various oral and topical antifungal medicines are available to treat yeast infections, including over-the-counter (OTC) products such as Monistat®. You should talk with your doctor before using an OTC product, especially if your blood sugar level is not normal and you have recurring yeast infections.
Urinary incontinence
Urinary incontinence, which simply means you can’t always control when you urinate, is more common for women with diabetes and women with impaired fasting glucose (IFG or pre-diabetes). Postmenopausal women seem to have a higher incidence of this uncomfortable and often embarrassing condition. It seems that the longer you have had diabetes, and if you have peripheral neuropathy (nerve problems) and retinopathy (eye problems), your symptoms might be worse. As with most diabetes-related complications, treatment includes good blood glucose management. Being overweight also may increase your risk.
Since there is more than one cause of urinary incontinence, you should consult your health care team to determine the cause and be treated appropriately. Treatments include Kegel exercises (exercises that strengthen the muscles of the pelvic wall), bladder training and medications. Surgery is an option if these other solutions don’t work.
Premature menopause
The average age a woman goes through menopause is 51. Menopause before age 40 is considered premature and may be related to immune disorders such as Type 1 diabetes. Just as your body fights your pancreas when you have diabetes (which is why they call it an autoimmune disease), the same may be true for your ovaries. The result is that you stop the production of female hormones. The concern with premature menopause is increased risk of heart disease, osteoporosis and for some women, fertility. Treatment for your menopausal symptoms is similar to those for any woman going through menopause: good medical care, nutrition, physical activity, and possibly hormone replacement therapy. This is something you should discuss with your health care team as well as infertility. Changes in hormonal levels and balance often lead to blood glucose levels that are out of control. It may take some extra monitoring and adjusting to regulate your blood glucose during this time.
Sexual intimacy
Hormones are related to sexual desires and comfort. We usually associate the hormone estrogen with women. But you have more hormones than just estrogen. Remember, insulin is a hormone too, and hormones affect each other. For example, some women need more insulin before and during their periods. This is due to hormonal shifts. These shifts can cause mood changes, which may decrease your desire for sex. They also can cause vaginal dryness, which can cause sex to be painful.
Many women take other medications that may affect sexual desires. Again, good blood glucose management is crucial to you with your moods and hopefully your lubrication. Consult your health care team to see if any of your other medications may be causing problems. Lubricants such as K-Y® Jelly can help prevent vaginal dryness. Water-based personal lubricants are generally less irritating than oil-based ones.
Birth control pills
You can use birth control pills, but they can increase blood glucose levels and using them for longer than a year or two may increase your risk of complications. For instance, if you develop high blood pressure while on the pill, you increase the chance of eye or kidney disease. Be sure to monitor your blood glucose and blood pressure when taking the pill, and work with your health care team to make any adjustments.
If you are a premenopausal woman who is not ovulating, you should know that thiazolidinediones (Actos® and Avandia®)—a class of oral diabetes medications used to lower blood glucose—might increase your risk of pregnancy by causing you to ovulate. Combination meds such as Avandamet®, Actoplus Met® and Avandaryl® that contain this medication also may have this effect. Your oral contraceptive may be less effective when taking these medications. Consult your doctor to make sure you are protected, and what to do about your medications and blood glucose management if you get pregnant while taking these medications.
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